Pharm Quiz 3

Question 1

What are adverse drug reactions?

Answer 1

any noxious, unintended, undesired effect that occurs @ normal drug doses

Question 2

What are mild ADR effects?

Answer 2

drowsiness
itching
nausea
rash

Question 3

what are severe ADR effects

Answer 3

respiratory depression
organ injury
anaphylaxis
death

Question 4

what are ADR considerations?

Answer 4

What increases risks
what is the impact - for whom
how can harm be minimized

Question 5

What is a side effect?

Answer 5

a nearly unavoidable secondary drug effect produced @ therapeutic doses

Question 6

What is toxicity?

Answer 6

any sever ADR, regardless of the dose that caused it

Question 7

What is an allergic reaction

Answer 7

immune response, the intensity of which is determined by immune system, not dosage

Question 8

What is idiosyncratic effect?

Answer 8

uncommon response resulting from a genetic predisposition

Question 9

What is paradoxical effect

Answer 9

the opposite pf the intended drug response

Question 10

What is iatrogenic disease

Answer 10

occurs as the result of medical care or treatment, including disease produced by drugs

Question 11

What is physical dependence?

Answer 11

body has adapted to drug exposure in such a way that abstinence syndrome will develop if discontinued

Question 12

What is carcinogenic effect?

Answer 12

the ability of certain meds & chemicals to cause cancers

Question 13

What is teratogenic effect?

Answer 13

drug-induced birth deffect

Question 14

Hepatotoxic Drugs: What are the components

Answer 14

liver is primary site of metabolism
drugs are leading cause of liver failure
over 50 commonly given drugs are hepatotoxic
some drug metabolites are hepatotoxic
combining hepatotoxic drugs increases risk of liver injury

Question 15

What is DILIY

Answer 15

drug induced liver injury

Question 16

What are QT drugs?

Answer 16

prolong the QT interval

Question 17

What life-threatening thing can a QT drug cause?

Answer 17

dysrhythmias

Question 18

Are QT drugs found in several classes

Answer 18

yes

Question 19

Who is at a higher risk under QT meds

Answer 19

females

Question 20

QT drugs: What should not be given cocurrently

Answer 20

multiple QT drugs

Question 21

What do the kidneys do?

Answer 21

filter metabolites out of body

Question 22

What can cumulative exposure do to the kidneys?

Answer 22

can cause damage to the kidneys

Question 23

What reaction can cause permanent damage to the ears?

Answer 23

ototoxic

Question 24

What does this damage in the ears

Answer 24

can cause hearing loss so it’s very important to catch early

Question 25

How many drugs are pneumotoxic to the lungs?

Answer 25

over 600

Question 26

How do we look for adverse drug reactions?

Answer 26

underlying illness polypharmacy unknown

Question 27

What questions should we ask when we notice an adverse effect?

Answer 27

Did symps appear shortly after the drug was first used? Did symps abate when the drug was discontinued? Did symps reappear when the drug was reinstituted? Is the illness itself sufficient to explain the event? Are other drugs in the regimen sufficient to explain the event?

Question 28

What are ways to minimize ADRs?

Answer 28

Early id is key Know major ADRs that a drug can produce Monitoring of organ function if toxic drugs are being given Individualizing therapy Pt teaching

Question 29

What are black box warnings?

Answer 29

strongest safety warning a drug can carry & still remain on the market

Question 29

What are black box warnings?

Answer 29

strongest safety warning a drug can carry & still remain on the market

Question 30

What info do black box warnings contain?

Answer 30

concise summary of the adverse effects of concern - (warnings & precautions)

Question 31

Which med warning is the most serious by the FDA?

Answer 31

Black box warning

Question 32

What should we consider before giving a black box med to a pt?

Answer 32

does the potential benefit of treatment outweigh the risk? are there safer (& equally effective) alternatives? would a safer but less effective alternative be appropriate? is the boxed warning applicable to this specific pt? can action be taken to ameliorate the potential for an adverse reaction?

Question 33

What is the definition of medication errors?

Answer 33

any preventable event that may cause or lead to inappropriate medication use or pt harm while the medication is in the control of the healthcare professional, pt, or consumer"

Question 34

How many types of med error are there?

Answer 34

13 types

Question 35

What factors cause med errors?

Answer 35

human factors communication mistakes = 90% of fatal errors Name confusion Packaging, formulations, & delivery services Labeling & reference material

Question 36

What are the factors affecting individual response?

Answer 36

Body composition Age Pathophysiology Tolerance Comorbidities & drug interactions Diet

Question 37

How does body composition affect individual response?

Answer 37

If the same dose of a drug is given to a big person & a small person, the drug concentration will be higher in the smaller person

Question 38

Why does age affect individual response (infants)?

Answer 38

immature organ systmes

Question 39

Why does age effect individual response (older adults)?

Answer 39

decline in organ function

Question 40

How does pathophysiology affect the individual response? (kidney disease)

Answer 40

reduces rate of drug excretion - drugs may accumulate to toxic levels

Question 41

How does pathophysiology affect the individual response (liver disease)?

Answer 41

Reduces rate of drug metabolism - drugs may accumulate to toxic levels

Question 42

If there are more drugs in the system what happens to the liver & kidneys

Answer 42

decline in function of liver & kidneys

Question 43

How does tolerance affect individual response?

Answer 43

decreased responsiveness to a drug as a result of repeated drug admin

Question 44

How do comorbidites & drug interactions affect individual response?

Answer 44

drugs taken to manage one condition may complicate management of another condtion

Question 45

How does diet affect individual response?

Answer 45

good diet can elicit therapeutic responses & reduce harm from ADRs some foods can interact w/ drugs & cause ADRs

Question 46

What can cause failures in taking drugs?

Answer 46

Pt compliance Medication errors

Question 47

How does pt compliance affect the pt taking drugs?

Answer 47

manual dexterity & visual acuity intellectual capacity & psychological state attitude & belief toward drugs Can happen at any step in the process

Question 48

Who is the last line of defense for med errors

Answer 48

nurse

Question 49

What are geriatric concerns when given meds?

Answer 49

organ function comorbities polypharmacy noncompliance

Question 50

What are Pharmacokinetic Changes: ADME (Elderly)?

Answer 50

Absorption Distribution Metabolism Excretion

Question 50

What are Pharmacokinetic Changes: ADME (Elderly)?

Answer 50

Absorption Distribution Metabolism Excretion

Question 51

What changes absorption in the elderly?

Answer 51

rate of absorption slows gastric acidity declines

Question 52

What changes in distribution occurs in the elderly?

Answer 52

increased body fat % - plasma drug levels reduced decreased % lean body mass - plasma drug levels increased decreased total body water - plasma drug levels increased Decreased serum albumin concentration - plasma drug levels increased

Question 53

What changes in metabolism occur in the elderly?

Answer 53

tends to decline w/ age which is highly variable

Question 54

What changes in excretion occur in the elderly?

Answer 54

begins to decline progressively in early adulthood the most important cause of ADRs in older adults

Question 55

ADRs are how many times more likely in older adults?

Answer 55

7 times

Question 56

ADRs account for what percentage of hospital admissions in older adults?

Answer 56

16% of hospital admissions

Question 57

ADRs account for how many percentage of deaths related to medication?

Answer 57

50%

Question 58

What are mostly dose related?

Answer 58

ADRs

Question 58

What are mostly dose related?

Answer 58

ADRs

Question 59

What are mostly dose related?

Answer 59

ADRs

Question 60

Are symptoms specific or nonspecific for ADRs in the elderly?

Answer 60

they are mostly dose related

Question 60

Are symptoms specific or nonspecific for ADRs in the elderly?

Answer 60

nonspecific

Question 61

Are older adults likely to share alcohol or recreational drug use?

Answer 61

not very likely

Question 62

Are ADRs mostly avoidable

Answer 62

yes

Question 63

What are the important risk factors we should know for the elderly?

Answer 63

reduced renal function - drug accumulation polypharmacy greater severity of illness low therapeutic index of drugs increase individual variation inadequate supervision of long-term therapy poor adherence

Question 64

What are the goals of treatment?

Answer 64

reduce symps improve QOL

Question 65

What should we determine when assessing pt's?

Answer 65

drug history compliance

Question 66

What should we be looking for when we monitor a pt we have given meds to?

Answer 66

clinical responses plasma of drug levels

Question 67

What should we teach when giving a pt meds?

Answer 67

how to take meds Strats for complience

Question 68

How should we advocate for our pt when they are taking meds?

Answer 68

simpilest regimen possible Easy to open containers large print cost